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Insurance Investigator Jobs

Updated on March 12, 2011

The insurance industry is one adversely affected by fraudulent claims.  Insurance investigator jobs are an invaluable service that identify and helping resolve fraudulent claims that are specific to that industry. Much of the investigation work needed by insurance companies is outsourced and handle primarily by a private investigator. This can be a great career choice for properly qualified individuals.

Some states require an apprenticeship under a licensed private investigator.  Licensing, certification, and business liability insurance requirements vary from state to state.  Knowing your state’s requirements is simply a matter of contacting the appropriate licensing bureau.  

A good private investigator may be able to handle many types of case work.  From security details to more complex proprietary and intellectual property investigations, today’s private eye needs to be educated, flexible, and creative.  The true bread-and-butter work, however, is the work of the insurance investigator.  Insurance investigator jobs are virtually recession proof, simply because there is always someone looking to defraud an insurance carrier.

Most accident or injury claims are legitimate, and it is only the possibly fraudulent claimant that spurs an insurance investigation. Individuals may be injured at work.  Others may be involved in a vehicle accident, and the insurer of the “at fault” party may be paying benefits to the injured person.  The bulk, however, once recuperated, will return to their jobs and their regular lives.  

Insurance Investigator Jobs - Who is Investigated?

There is a minority for whom the lure of an easy dollar is too tempting.  These people conspire to continue to receive benefits where there is no longer a need.  These are known as “malingerers” (ones who pretend incapacity, such as illness, to avoid duty or work). 

Others will exaggerate an injury (whether real or not) to draw an income.  Some want the security of a steady paycheck without having to work.  Then there are the professional criminals – insurance fraud (from arson of houses that are “built to burn”, “slip and fall” people, or professional “car accident” victims) costs millions to the insurance industry annually.  Insurance investigator jobs are, not surprisingly, commonly associated with personal injury claims.

What determines if an individual is suspected of malingering?  Some indicators are: he/she is often not home, doesn’t keep required doctor’s appointments, and often cannot be reached by telephone.  The insurance investigator, at the direction of an insurance claims adjuster, will begin an investigation with basic facts.  The adjuster provides details about the subject (current address, etc.) as a starting point. 

Investigation and Documentation

The most powerful tool of the insurance investigator is surveillance. Discreetly, the investigator maintains observation of the claimant’s residence and activities. The focus of surveillance is to document the subject’s activities. This can be in the form of video and photographs. Does the man alleging a “bad back” spend time each day digging flower beds with a shovel in his front yard? Is the woman who claims her “legs hurt” seen jogging a few miles every morning?

A crucial element of insurance investigator jobs is the written report. This is presented to the client at the end of the investigation, and contains an account of observations, and may also include recommendations for further investigation. This report serves as a legal document and should be professionally prepared. Often, the investigator who conducted the surveillance may have to appear in court and testify on behalf of the client, using his report as source material.

A good investigator, whether on an insurance company’s payroll or working on his/her own, can make a very lucrative living from insurance investigator jobs. Not only will this help keep the cost of insurance down for everyone, but many people who choose this career path feel a professional pride from helping businesses protect themselves from fraud. It may be the right time for you to "investigate" how to become a private detective or insurance investigator.

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    • kenneth avery profile image

      Kenneth Avery 

      6 years ago from Hamilton, Alabama

      Hello, sound_foundation, you are right. What we see on television is far from the reality of life. And you are right also on the insurance investigation being a good career choice for the right person. I attend church with a guy who works for a mortgage company. His job is to go to the houses on the company's list and take photos of the houses...I asked him if that might be dangerous, he laughed and said not much. Now consider this. He is Six Foot 5" and weighs around 290...he could easily play Defensive End for Michigan, Ohio State and my beloved Crimson Tide. But he is a quiet, humble and hard-working guy whom Ive forged a solid friendship with and would call on him anytime when in a street fight which is as possible as gas prices going down below $3.00/gal. Merry Christmas to you and yours.

    • sound_foundation profile imageAUTHOR

      sound_foundation 

      6 years ago

      Hey Kenneth, I appreciate you taking the time to leave your kind words. All too often, people think of a private investigator as "seen on TV". The real world is far more mundane, usually, but it can be a great career choice for the right person.

    • kenneth avery profile image

      Kenneth Avery 

      6 years ago from Hamilton, Alabama

      12/7

      Sound_Foundation---GREAT read. Good advice and very informative. Voted up and all the way. You are a super-talented writer, my friend. Many should read this before they jump into insurance investigations. YOU brought out many good points. I apologize to you for not visiting with you as much as I should. Ive been working on as many publishing projects as I could before my health worsens. I am very sorry. But you keep up the great hubbing and have a Merry Christmas. (((Peace)))

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